Healthcare Provider Details

I. General information

NPI: 1861438038
Provider Name (Legal Business Name): MICHAEL SCOTT KINNE PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2006
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2030 LAY DAM RD
CLANTON AL
35045-8344
US

IV. Provider business mailing address

2030 LAY DAM RD
CLANTON AL
35045-8344
US

V. Phone/Fax

Practice location:
  • Phone: 205-755-6110
  • Fax: 205-755-6108
Mailing address:
  • Phone: 205-755-6110
  • Fax: 205-755-6108

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number14501
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTH4021
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: